After preparing and submitting documents to the Magnet Recognition Program®, you and your colleagues wait, hoping for a phone call to announce a site visit, the next step in the process of obtaining designation as a Magnet® organization. Finally, the anticipated phone call occurs, and the visit is scheduled. You and your colleagues experience a flood of emotions as you begin preparing for this high-energy event.
The Magnet Recognition Program identifies healthcare organizations that provide quality patient care and achieve excellence in professional nursing practice. Nursing staff must take specific steps for their facility to achieve this recognition. Early steps include submitting an application and preparing and submitting supporting documentation. In this article, I’ll discuss, based on my experience, how to manage the next part of the process—a site visit by appraisers from the American Nurses Credentialing Center (ANCC), the organization that grants Magnet recognition.
Your site visit may be scheduled anywhere from 4 to 9 months after you submit your documentation. The timeline differs for every organization. Once site visit dates are confirmed, the ANCC Magnet office emails the chief nursing executive (CNE) and the designated Magnet Program Director (MPD) at your facility. This email marks the official start of the site visit phase of the Magnet recognition process, although I recommend that you begin preparing for the visit before you receive this email. (See Getting started: Resources to help prepare for a site visit.)
Staff members take on a variety of roles when getting ready for a site visit. When assigning roles, consider who can best meet the associated responsibilities rather than focusing on titles. (See Site visit roles and responsibilities.)
Preparing for a site visit is a major undertaking. To help make sure your site visit is successful—be flexible, stay focused, encourage staff to engage appraisers, and be prepared. And, yes, have fun.
Coordinating the site visit
The MPD coordinates the site visit and oversees all activities. If you take on this role, expect to:
• Work with the lead appraiser from the ANCC to set the site visit agenda.
• Send the lead appraiser your facility’s unit staffing schedules for site visit dates. Scheduling information is used to select participants for the breakfast, lunch, and dinner interviews.
• Add to the agenda any interviews that, although not requested by the lead appraiser, may be helpful in obtaining Magnet recognition. Share your recommendations and reasons for wanting to add these interviews. For example, my team added an interview with a group of staff who had attended a Magnet conference to our site visit agenda.
• Notify people scheduled for interviews.
• Confirm the time as soon as possible for community members and other people scheduled for interviews who are not on staff. If someone scheduled for an interview is not available during the requested time, notify your lead appraiser.
• Update documentation. Consider how much time has passed since you submitted Magnet documents. You may need to update your site’s patient satisfaction, quality indicators, nursing satisfaction, and nurse education and certification material.
As MPD, you must have a strong understanding of all aspects of a site visit. My advice: Don’t try to do it all yourself. Plan to partner with others during each phase of the visit. Seek administrative support to help book meeting rooms, schedule interviews, organize meals for appraisers, schedule meals for interviewees make travel arrangements, and coordinate completion of the attendance roster for each interview.
Another important role is serving on the Magnet Tracer Team. This team is responsible for educating staff in preparation for the site visit. Our organization established five Tracer Teams consisting of five members each.
Members of the Tracer Team were instrumental in creating a series of newsletters focused on pre – paring staff for the site visit. Newsletter content was based on concepts from the Magnet® Model, including transformational leadership, structural empowerment, exemplary professional practice, and new knowledge, innovations, and improvements. We sent a newsletter each month to nursing units and other healthcare team members, starting about 6 months before the site visit.
In the course of a month, each Tracer Team visited six to 10 units and held rounds, asking staff questions related to the content of the most recent newsletter.
These rounds simulated interviews with Magnet appraisers. The next month, each Tracer Team rotated to different units.
Following each round, the team gave the MPD an evaluation of the strengths and weaknesses of the unit to help guide future activities. Once all newsletter topics were covered individually, Magnet Tracer Team members compiled all the questions and randomly selected review questions to allow for ongoing practice and to help staff build confidence.
We also created a newsletter titled Magnet Is for Everyone targeted toward nonnursing employees, such as guest services, environmental services, and building operations, as well as volunteers, and another newsletter to provide basic Magnet information for physicians.
Reinforcing Magnet concepts
Committees working on Magnet recognition collaborated to organize an engaging kickoff event for both clinical and nonclinical staff—the Fall Festival. Participants visited educational stations that featured games to reinforce concepts essential to Magnet recognition; for example, a spin-the-wheel station to reinforce concepts of transformational leadership, a duck pond game to teach about structural empowerment, a trivia game to reinforce exemplary professional practice, and Bozo buckets to reinforce new knowledge concepts.
As a further step to keep employees informed, we provided each unit with a customized binder that contained the following items:
• updated, unit-specific graphs of key indicators
• patient and nursing satisfaction graphs
• tips for conducting unit rounds
• the nursing strategic plan
• presentations on topics related to Magnet recognition
• questions from the Tracer Team
• Fall Festival questions
• a summary of projects included in the Magnet document submission.
Some units created a bulletin board to display materials.
Preparing staff for interviews
The MPD conducted sessions to prepare each team scheduled for appraiser interviews about 8 weeks before the site visit. The MPD provided examples of materials interview teams could take to the interview, materials already sent to appraisers, and new material to be shared with the appraisers once on site.
Interview teams have 60 minutes to share their accomplishments with appraisers. Encourage them to be creative. For example, our nursing research council displayed research and evidence-based practice posters throughout the interview room during their session.
Helping keep to schedule
During the site visit, appraisers will seek to verify, amplify, and clarify the contents of your Magnet application. They will hold meetings in many different locations at your site. Magnet escorts are responsible for making sure the appraisers arrive at the right place at the right time. Escorts and appraisers spend a lot of time together, so fostering successful relationships between them is important.
You’ll need to create an escort schedule that works for your organization. We implemented 4-hour shifts and matched escorts with appraisers according to clinical specialty.
Escorts have to know where, when, and to whom they need to hand off the appraiser under their charge. A team of clinical and nonclinical staff who provide consistent focus on Magnet recognition over the years, the Magnet Advisory Council met with the escort team for the site visit. At the meeting, escorts introduced themselves and reviewed expectations and schedules for the visit. During the visit, each escort used a worksheet to document the names of patients who interacted with appraisers, key questions asked by appraisers, files requested, and physician interactions.
Escorts need strong time-management skills. They should carry a cellphone, know key phone numbers, and be familiar with the patient population of the units they’ll be visiting. Responsibilities include making sure appraisers have plenty of bottled water and pointing out where bathrooms are located. When meeting an appraiser for the first time, the escort should ask how he or she prefers to be notified about time limits.
Enhancing the experience
We developed an onsite resource called an Appraiser Guidebook, which was customized for each appraiser. Guidebooks were placed in each appraiser’s hotel room on arrival day. The book included copies of the site visit staff notice, the public notice, updated unit graphs, background information on each escort, attendance rosters by interview, unit descriptions, and any new information provided by interview teams.
During the site visit, designate one room in your facility as the appraisers’ homeroom. This way, they have a place to store their belongings, as well as to debrief with the CNE, the MPD, or each other. They can also use this room for onsite document review. Appraisers often are conducting interviews and taking notes while everyone else is eating, so make sure you have grab-and-go food items available for them in this room and at the hotel.
The end of the visit: What’s next?
Thank the appraiser team before they leave for the airport as the site visit ends. Debrief with staff and team leaders. Share appraiser comments, determine what worked well, and get feedback on how the experience could be improved for the next time. Be sure to thank everyone for his or her hard work and contributions.
Take satisfaction in the positive effects the site visit had on your organization and the professional growth it inspired. More than likely, you worked long hours to prepare for it. Now organize your office, refocus on other work responsibilities, spend time with your friends or family, or even take a vacation. And be patient. You may wait as long as 8 weeks before learning whether you received Magnet recognition. (See Three key points about preparing for a Magnet® site visit.)
Wendy Tuzik Micek is director, nursing science, and Magnet Program Director at Advocate Christ Medical Center and Advocate Children’s Hospital in Oak Lawn, Illinois.
American Nurses Credentialing Center (ANCC). 2014 Magnet® Application Manual, 2014 edition. Silver Spring, MD: American Nurses Association; 2013.